Individual
LESLIE CORINN JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
901 E 5TH ST, WASHINGTON, MO 63090-3127
(636) 239-8090
(636) 390-7385
Mailing address
901 E 5TH ST, WASHINGTON, MO 63090-3127
(636) 239-8090
(636) 390-7385
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
2004034999
MO
367500000X
Certified Registered Nurse Anesthetist
23936
SC
367500000X
Certified Registered Nurse Anesthetist
Primary
AP133826
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN3303
—
SC
01
—
P00680827
RAILROAD MEDICARE
MO
Enumeration date
06/06/2007
Last updated
06/05/2025
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